LET’S GET READY STUDENT APPLICATION



LET’S GET READY STUDENT APPLICATION

Welcome to Let’s Get Ready! This application should take approximately

30 minutes to complete. You must answer all the questions. Please

Today’s Date:

Site Applying To: ________________________________________

BASIC INFORMATION

First Name: _______________________ Middle Initial: ____________ Last Name: ______________________________

Gender: (circle one) Male Female Other Birth date (MM/DD/YY): __________________

Street Address: _____________________________________________________________________________________

Apt. #: ______ City: ____________________________________ State: _______ Zip: ____________________________

Home Phone Number: ___________________________ Cell Phone Number: __________________________________

Email: ___________________________________________ SSN: _____________(OR Alien ID#: __________________)

How would you describe yourself? (you can choose more than one)

|American Indian or Alaska Native |Asian, Asian American or Pacific Islander |

|Black or African American |Caucasian or White |

|Mexican or Mexican American |Puerto Rican |

|Hispanic, Latino or Latin American |Other: _______________________ |

What language do you feel MOST proficient in (reading, writing, speaking)? (please circle one)

|English |Spanish |Vietnamese |Chinese |French |Other: |

Please circle your approximate family income: (please circle one)

|Less than $20,000 |About $20,000 to $40,000 |About $40,000 to $60,000 |About $60,000 to $80,000 |More than $80,000 |

Total Number of people in household (including yourself): _____

High School: ________________________________________________________________________________

Grade Level (Circle One) (If summer, what grade are you entering in the fall?): 10 11 12

Anticipated Graduation Date (MM/DD/YY):_____/______/__________

Guidance Counselor/ College Counselor Name: __________________________________________________________

Cumulative Grade Point Average: ___________________

If you do not know your exact cumulative GPA, please circle one of the following:

A (90-100) B (80-89) C(70-79) D(65-69) F(Below 65)

How did you learn about LGR? (Circle One)

|School |Community Program (ex.TSTT, NYU Upward Bound) |

|Who within the school? __________________ |Which one? ______________________________ |

|Friend |Internet |

|Church |Family Member |

|Parent |Other: ___________________________________ |

***If you are applying for the Brooklyn site ONLY***

Check which, if any, of the following referred you to the Let’s Get Ready program:

▪ College Now at City Tech

▪ STEP at City Tech

▪ SIMBA

ELIGILBILTY INFORMATION

Please circle the statement that applies to you:

▪ I have never been enrolled in the Free or Reduced Price Lunch.

▪ I am currently enrolled in or eligible for the Free or Reduced Price Lunch.

▪ I was enrolled in the Free or Reduced Price Lunch, but I no longer am.

▪ Everyone in my school receives a free lunch.

Please circle Yes/No

Have you attended an SAT preparation course before? Yes No

If yes, was it with LGR? Yes No

If LGR didn’t exist, would you be able to afford an SAT prep program such as Kaplan or Princeton Review? Yes No

Parent Information

Parent/ Legal Guardian 1:

Circle One : Mother Father Legal Guardian Other: __________________________________________

Name: ____________________________________________________________________________________________

Daytime Telephone: _____________________________ Evening Telephone: ___________________________

Occupation: _______________________________ Email: ________________________________________________

Highest Level of Education Completed (Circle one):

|Some high |High school degree |Some college |Received Associate’s Degree or 2-year |Received Bachelor’s Degree or 4-year |Received Graduate Degree |

|school |or GED | |degree |degree | |

Parent/ Legal Guardian 2:

Circle One : Mother Father Legal Guardian Other: __________________________________________

Name: ____________________________________________________________________________________________

Daytime Telephone: _________________________ Evening Telephone: __________________________________

Occupation: _______________________________ Email: _____________________________________________

|Some high |High school degree |Some college |Received Associate’s Degree or 2-year |Received Bachelor’s Degree or 4-year |Received Graduate Degree |

|school |or GED | |degree |degree | |

Highest Level of Education Completed (Circle one):

Please list your other time commitments during the period in which you are applying to attend Let’s Get Ready!

Activity Days of the week Times Dates*

1. ________________________________________________________________________________________________

2. ________________________________________________________________________________________________

3. ________________________________________________________________________________________________

4. ________________________________________________________________________________________________

Please circle the statement that most closely applies to you.

I definitely want to go to college after high school and I already have a list of possible colleges.

I definitely want to go to college, but I haven’t thought much about the college process.

I definitely want to college, but I have not started thinking about the college process.

I am still deciding if I want to attend college.

Essay Question

Let’s Get Ready considers many factors when selecting students for the program. They include your reasons for wanting to attend college, your family background (income, whether you might be the first person in your family to attend college). What will you contribute to the program as part of the LGR team, and what you hope to gain through participation? Please tell us about yourself and why you are an excellent candidate for the program (If you need more space, feel free to attach a separate sheet)

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LET’S GET READY STUDENT APPLICATION

Welcome to Let’s Get Ready! This application should take approximately

30 minutes to complete. You must answer all the questions. Please

answer as honestly and completely as possible. Your answers are confidential.

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